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Biomedical subjects

H W Linde

Publications and source records attributed to H W Linde.

28 records · Page 2Linked to original sources
PubMedDate not supplied

Hemodynamic and catecholamine responses associated with extracorporeal shock wave lithotripsy.

Patients undergoing extracorporeal shock wave lithotripsy (ESWL) for nephrolithiasis are anesthetized and immersed in water in a semisitting position. Hypertension and tachycardia have been reported to accompany ESWL, and it was hypothesized that those problems were a result of adrenal medullary release of epinephrine or norepinephrine. Therefore, the effects of ESWL on cardiovascular variables and circulating epinephrine and norepinephrine levels in nine patients anesthetized with 1.1% isoflurane in 50% nitrous oxide and oxygen were studied. End-tidal carbon dioxide (CO2) was maintained at 34 +/- 2 mmHg. Cardiac output (CO) and mean arterial pressure (MAP) were measured, and total peripheral resistance (TPR) was calculated at the following time points: (1) after immersion prior to shock wave therapy (control); (2) after 300 shocks; (3) after 800 shocks; and (4) 5 minutes after the completion of ESWL with the patient still immersed. Circulating epinephrine and norepinephrine concentrations were determined at the above times as well as before and after induction of anesthesia but prior to immersion. There was a statistically significant (p less than 0.05) decrease in CO and an increase (p less than 0.05) in MAP and TPR with ESWL treatment. These values returned to baseline levels when treatment was stopped. Plasma epinephrine and norepinephrine values did not change significantly throughout the study period. It was concluded that these ESWL-associated hemodynamic changes were probably not mediated via epinephrine or norepinephrine.

Adult↗
PubMedDate not supplied

Cardiovascular effects of isoflurane and halothane during controlled ventilation in older patients.

Isoflurane or halothane was administered at two different inspired concentrations to 21 surgical patients whose average age was 62 years. Most were in physical status (ASA) II or III. Patients were premedicated with diazepam and atropine, anesthesia was induced with thiopental, and tracheal intubation was facilitated with succinylcholine. Respiration was controlled manually or with a ventilator. Anesthesia was maintained with 60 percent N2O and halothane 1 percent, then 0.5 percent, or with N2O-isoflurane 1.2 percent, then 0.6 percent in O2. Variations in the cardiovascular responses among patients given the same anesthetic were as great as the variation in responses between anesthetics. Both produced similar decreases in arterial pressure, cardiac output, and stroke volume. Changes in pulse rate were minimal, and total peripheral resistance changes quite variable, for both drugs. Both halothane and isoflurane appear satisfactory for inhalation anesthesia in the elderly.

Age Factors↗